Mild heart attack - blockages discovered - CABG or not?

[GeneSF]

Hi...I’m a 49-year old resident of San Francisco, CA.

I just had a mild heart attack. After an angiogram, they found blockages and recommended immediate CABG.

The concerning ones are a 70% blockage of the left main coronary artery at the bifurcation point (the right side going straight down, the left bifurcation is 20% blocked)), and a 90% blockage at the bifurcation for OM2. The 90% starts above OM2 and continues down right bifurcation  a little (left one is clear).

Because the blockages are at bifurcations, I’m not a candidate for stents.

I’ve been looking at options including robotic surgery, not doing anything, medicine only, etc.

The drs at my hospital insist I’m high risk and need the procedure right away. That if I want to go anywhere else for treatment, I need medical transport. That air flight is out of the question. I got to the point where I was afraid to leave my bed.

It’s been 12 days since my heart attack and I feel I’m regaining some strength. This morning I walked the halls at a brisk pace for about 5,000 feet total without symptoms. My heart rate stayed under 85 bpm. Oxygen stayed at 96% and above.

I admit I got tired afterwards and needed to nap 30 minutes.

I’m feeling maybe I do have the option of leaving the hospital and consulting with a local dr for advise.

One of the worlds leading robotic surgeons said he would take my case, but I would have to get myself to Chicago which means travel.

I’m in a quandary. Do I just go with blind trust in the drs here at one of the leading hospitals in the U.S., or do I take a risk and leave against their recommendations?

[winston5]

I do not have and answer for you but I believe you need to get a second  opinion from some other Dr.  It sounds like it could be very serious go get a second opinion it may just save your life. best wish's for you please get a second opinion. Just do not brush it off.

[Ger57]

Hi,

I am not a doctor but the assumption "because the blockages are at bifurcations, I’m not a candidate for stents". is just not right.
There are many options for successful stenting at bifurcations (two-stent procedure), although it may require extra skill from the cardiologist.

I would prefer a second opinion from an experienced cardiologist. Perhaps you do not need to leave the hospital for that. Just transfer all data to him.

[GeneSF]

I asked about that, and the idea of two-stent procedure was dismissed right away as introducing potential complications.

[winston5]

I had three stents put in in less than 1 and one half hours you need to see another Dr. and that was after Quadruple bypass 4 months ago just had the stenting  last week because the grafts were clogging up and I was beginning  to have heart failure again. So they stented the old veins see they were not completely blocked so they stented them open.  I am 64.